Background: Chronic nonspecific low back pain (CNLBP) is a common musculoskeletal condition among middle-aged adults, often causing physical limitations and reduced quality of life. Transcutaneous electrical nerve stimulation (TENS) is a widely used non-pharmacological method for pain relief and muscle modulation. Objectives: To compare the effects of two high-frequency, high-intensity TENS protocols on pain, muscle tone, and stiffness in individuals with CNLBP. Design: Single-blinded, randomized controlled trial. Methods: Twenty-eight individuals with CNLBP were randomly assigned to an experimental group (EG) or control group (CG). Both received 60 Hz, highintensity TENS twice weekly for four weeks. Pain equivalent current (PEC), visual analogue scale (VAS), pain degree (PD), muscle tone (Hz), and stiffness (N/m) were measured pre- and post-intervention by a blinded assessor. Results: The EG showed significant improvements in all outcomes (P<.05), while the CG showed significant change only in VAS scores. Between-group analysis showed greater reductions in pain and muscle-related variables in the EG. Conclusion: The EG protocol, with individualized intensity adjustments and targeted stimulation sites, was more effective than the CG protocol in improving pain, muscle tone, and stiffness in adults with CNLBP.

Background: Recent research suggests that the most effective and proactive method for correcting excessive pronation, which contributes to the lowering of the medial longitudinal arch, is to enhance both intrinsic and extrinsic foot muscles simultaneously. Objectives: This study aims to compare the effects of intrinsic and extrinsic foot muscle exercises on medial longitudinal arch height, plantar pressure distribution, and lactate levels in university students with flexible flatfoot. Design: Randomized controlled trial study. Methods: Twenty-two students with flexible flat foot participated in this study and were recruited by N University in Korea. The subjects were randomly divided into Intrinsic foot muscle strengthening group (IFG; n=11) that went through Intrinsic foot muscle strengthening exercise, Extrinsic foot muscle strengthening group (EFG; n=11) that went through extrinsic foot muscle strengthening exercise. SPSS was used for statistical analysis. Results: Both groups showed significant increases in medial arch height and first metatarsal bone pressure, while EFG also had increased pressure at the second to fourth metatarsal bones. No significant differences were found in lactate levels. Conclusion: Both intrinsic and extrinsic foot muscle strengthening exercises can be suggested as effective interventions for improving medial longitudinal arch height and plantar pressure.

Background: Chronic ankle instability (CAI) is very common disease. Strength exercise, balance exercise, and proprioceptive exercise were used to improvement of function for CAI. Isokinetic strength and balance are related to functional movement of lower extremity. Objectives: The purpose was to analyze the effect of muscle strengthening exercise, balance exercise, and proprioceptive exercise on isokinetic strength and balance in young adults with CAI. Design: Randomized controlled trial. Methods: The subjects were 30 young adults with CAI. The subjects randomly divided into three groups: strengthening exercise, balance exercise, and proprioceptive exercise. They performed each exercise for 20 minutes, three times a week for four weeks. They measured isokinetic strength of dorsiflexor and plantar flexor of 60°/sec and 120°/sec, static and dynamic balance before and after exercise. Results: The isokinetic strengths of dorsiflexor and plantar flexor of 60°/sec and 120°/sec were significantly higher in the strengthening exercise group than in the balance exercise group. The static and dynamic balance was significantly higher in the balance exercise group than in other two groups. Conclusion: Strengthening exercise, balance exercise, proprioceptive exercise can improve the muscle strength for CAI. Strengthening exercise and balance exercise can more improve balance than proprioceptive exercise for CAI.

Background: Child care center teachers are exposed to musculoskeletal injuries caused by repetitive movements at low heights due to the nature of their jobs. Self-myofascial release (SMFR) improves flexibility, pain, and functional performance. Pectoralis minor self-stretching (PMSS) improves muscle flexibility and postural alignment. PMSS has been commonly used to correct a rounded shoulder posture (RSP). Objectives: To examine the shoulder height, muscle tone, muscle stiffness, and muscle elasticity for women child care center teachers with RSP. Design: Randomized study. Methods: The participants were 20 women child care center teachers with RSP. They were randomly assigned two groups: SMFR group (n=10) and PMSS group (n=10). They performed each exercise for 20 min, 3 times a week for 4 weeks. They measured shoulder height, muscle tone, stiffness, and elasticity of upper trapezius before and after exercise. Results: In the shoulder height, there was no significant difference between two groups. There were significant decreases within both groups. In the muscle tone, stiffness, and elasticity, there was no significant difference between two groups and within two groups. Conclusion: SMFR using a hard massage ball and PMSS have a positive effect on posture correction for child care center teacher with RSP.

Background: Although recent studies using virtual reality have been actively conducted, studies on exercise therapy interventions and changes in muscle characteristics in patients with scoliosis are limited. Objectives: To investigate the effects of trunk and pelvic exercises program using virtual reality on the characteristics of paraspinal muscles in patients with scoliosis. Design: A randomized controlled trial. Methods: Thirty college students with scoliosis were randomly assigned to the trunk and pelvic exercise program using virtual reality group (VRG; n=15) and the general stretching exercise group (SG; n=15). The intervention was conducted three times a week for 8 weeks for 30 min per session. The recorded variables were muscle tone (F), muscle stiffness (S), and muscle elasticity (D). The collected data were analyzed after statistical processing. Results: In the cervical vertebrae, F showed significant differences in the amount of inter-group variation in the VRG compared that in the SG on the right side. The VRG showed significant increases in intra-group variation on both the right and left sides. S showed significant differences in the amount of inter-group variation in the VRG compared to that in the SG on the right side. With regard to the intra-group variation of F in the thoracic vertebrae, the right muscle in the VRG demonstrated significantly increased after the experiment, while D significantly increased in the left muscle in the VRG. Conclusion: Pelvic and trunk exercises program using virtual reality may be applied a better therapeutic intervention for patients with scoliosis.

Background: Thera-Band, Narrow squats, Kinesiology taping helps in the reduction of loading on the knee joints. Despite the fact that the varus knee negatively affects the alignment of the lower extremities, most of the studies have analyzed each independently. Objectives: To investigate the effects of a complex exercise program consisting of elastic band exercises and squat exercises on the distance between the inner knees and balance in young adults with genu varum. Design: A cluster randomized controlled trial. Methods: The complex exercise group performed resistance exercises using an elastic band. The taping group used kinesiology tape on the vastus lateralis and biceps femoris. To select those to be included in the study, we measured the distance between the knees using digital Vernier calipers and to measure the balance ability, we used a balance training system. The data were analyzed with the independent t-test and paired t-test. Results: The study indicated a significant difference in the distance between the knees between the two groups, but no significant differences in the dynamic balance between the groups. Also, the static balance comparison between the groups according to the intervention method included the trace length, C90 area, C90 angle and velocity. There were no significant differences in the static balance between the groups. In addition, the complex exercise program was more effective than taping. Conclusion: The results of this study demonstrate that the complex exercise program and taping decrease the between both the knee and increase the balance.

Background: Chronic ankle instability is a common injury that decreases balance and negatively affects functional movements, such as jumping and landing. Objectives: To analyze the effect of taping types and jump heights on balance with eyes open and closed during jump landings in chronic ankle instability. Design: Within-subject design. Methods: The study involved 22 patients with chronic ankle instability. They performed both double-leg and single-leg drop jump landings using three conditions (elastic taping, non-elastic taping, and barefoot) on three different jump platforms (30, 38, and 46 cm). Balance was measured using the Romberg's test with eyes open and closed. Results: Interaction effect was not statistically significant. Balance with eyes open and closed was significantly improved in both the elastic taping and non-elastic taping conditions compared to the barefoot condition. There was no significant difference according to the jump height. Conclusion: Individuals with chronic ankle instability demonstrated increased balance ability with eyes open and closed when jump landing. Elastic taping and non-elastic taping on the ankle joint can positively affect balance during landing in individuals with chronic ankle instability.

Background : There is lack of studies on the effects of the bag-carrying style on the shoulder muscles and body alignment in adults with rounded shoulder posture (RSP). Objective: The purpose of this study was to investigate the effects of various bag-carrying styles on muscle tone, muscle stiffness and spinal alignment in 20 adults with RSP as they were walking on a treadmill. Design : Crossover Study Design. Methods: A subject performed treadmill walking for 15 minutes at a speed of 4 ㎞/ｈ while carrying three different types of bags: a backpack, a cross bag, and a shoulder bag. Results : The results showed that the main effect of timing was observed in the muscle tone for all the variables and in muscle stiffness only for the upper and lower trapezius muscles. As for the main effect of timing, the muscle tone of the upper trapezius and the pectoralis major significantly increased in all conditions, while the muscle tone of the lower trapezius significantly decreased in all conditions. The muscle stiffness of the upper trapezius significantly increased in all conditions, while the muscle stiffness of the lower trapezius significantly decreased in all conditions. As for the spinal alignment, the dimple distance data values significantly decreased for the cross-bag style. Conclusions : This study demonstrated that walking with a heavy bag, regardless of the bag-carrying style, increased muscle stiffness around the shoulders in adults with rounded shoulder posture, and walking with a crossbag also induced changes in spinal alignment.